J Korean Ophthalmol Soc.  2014 Mar;55(3):459-464. 10.3341/jkos.2014.55.3.459.

Spontaneous Separation of Idiopathic Epiretinal Membrane in an Elderly Patient

• Noh JH
• Kim HA
• Park TK
• Ohn YH

• KMID: 2218280
• DOI: http://doi.org/10.3341/jkos.2014.55.3.459

Abstract

PURPOSE
To report a case of spontaneous separation of idiopathic epiretinal membrane in an elderly patient.
CASE SUMMARY
A 61-year-old male presented with decreased visual acuity in the right eye. He was diagnosed with idiopathic epiretinal membrane (ERM) in the right eye and posterior vitreous detachment (PVD) in both eyes. The patient underwent pars plana vitrectomy and ERM removal in the right eye. At postoperative 1 year, his vision in the right eye had improved, but idiopathic ERM developed in the left eye and visual acuity in the left eye decreased. Three years later, the ERM in the left eye resolved spontaneously and his vision increased.
CONCLUSIONS
Herein we present a rare case of spontaneous separation of idiopathic ERM associated with a pre-existing PVD in an elderly patient and reviewed the available literatures regarding the possible mechanisms for the spontaneous separation of ERM in the presence of a pre-existing PVD.

Keyword

Epiretinal membrane; Posterior vitreous detachment; Spontaneous separation

MeSH Terms

Aged*
Epiretinal Membrane*
Humans
Male
Middle Aged
Visual Acuity
Vitrectomy
Vitreous Detachment

Figure

• 

  Figure 1. At initial visit of a 61-year-old male, idiopathic epiretinal membrane (ERM) in the right eye was noticed. There was no abnormal finding in the left eye. His visual acuity was 0.2 in the right eye and 1.0 in the left eye. Color (A) and red-free (B) fundus photograph demonstrates the ERM in the right eye. Fluorescein angiogram (C) shows no significant ERM-associated leakage. Optical coherence tomography (OCT) shows ERM with macular edema (D). Color (F), red-free (G) fundus photograph, fluorescein angiogram (H) and OCT (I) scan of the left eye shows no abnormality. Partial PVD of the right eye (E) and complete PVD of the left eye (J) were verified through B-scan ultrasonograph.

• 

  Figure 2. He underwent surgery of the right eye. At postoperative 1 year, his vision had improved to 0.6 in the right eye. Color (A), red-free (B) fundus photograph and fluorescein angiogram (C) demonstrates that the ERM has peeled off completely and iatrogenic retinal hemorrhage after surgical treatment was surrounded with a well-healed laser lesions. OCT scan (D) shows successfully removed ERM and decreased retinal thickness. 14 months later, in the left eye his vision had decreased to 0.7 and Idiopathic ERM was noticed. Color (E), red-free (F) fundus photograph and fluorescein angiography (G) demonstrates translucent whitish membrane over the fovea. OCT scan (H) shows hyperreflective membrane over the fovea and absence of foveal pit. The retinal thickness of foveola has increased to 360 μm.

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  Figure 3. 3.5 years after initial onset of ERM in the left eye, fundus color (A), red-free (B) photograph and fluorescein angiography (C) demonstrates spontaneous peeling of whitish membrane in the left eye. OCT scan (D, E) shows presence of foveal pit after spontaneous separation of ERM and residual membrane remnant on the retinal surface. The retinal thickness of foveola has decreased to 283 μm. In the left eye his vision had improved to 1.0.

Reference

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